Pre-Pregnancy Checklist Helps Prepare Couples

If you were to choose a program with pregnancy in mind, I'd prefer a low-impact program such as swimming, walking or biking. All these activities are easy on the joints and the baby. I have found that my intense runners and weight trainers tend to ease off considerably during pregnancy due to the changes they experience.

This isn't to say that they couldn't continue their routine but they tend to modify it considerably. In addition, vigorous exercise tends elevate the pregnant woman's heart rate above the American College of Obstetricians/Gynecologist's recommended maximum heart rate of 140 beats/minute.

In anticipation of pregnancy, it is a good thing to get in the habit of eating three healthy meals per day. For those of you who are underweight, expect your doctor to encourage you to eat a little more when you are pregnant.

If you are considerably overweight, don't be surprised if your physician encourages you to lose weight in advance of pregnancy. However, there is no specific weight at which pregnancy is unsafe provided that your weight hasn't caused you to have other health-related problems.

In addition to eating well, pre-pregnancy ingestion of folic acid has been shown to reduce the risk of certain nervous systems diseases such as spina bifida. The addition of 0.4 mg of folic acid at least a month prior to attempting conception is recommended.

If you have had a prior child affected with spina bifida or other related diseases, you may be advised to take up to 4 mg of folic acid daily. Folic acid can be found in enriched bread and leafy vegetables, or taken as a supplement.

Ingesting 1200 mg of calcium and taking a multivitamin each day are the other pre-pregnancy suggestions to ensure an adequate supply of nutrients for a developing fetus. Some women take a multitude of supplements prior to getting pregnant.

Although they may have certain beneficial effects in the non-pregnant state, nobody can say for certain whether supplements are or are not safe during pregnancy. It has been discovered that Vitamin A in doses above the RDA (recommended daily allowance) can be hazardous to the fetus, with the potential to cause birth defects.

I often suggest to patients to discontinue all their vitamin supplements and take a daily prenatal vitamin in anticipation of getting pregnant. This way, a woman doesn't have to worry about whether she is getting the proper amount of each vitamin and mineral.

Vaccinations and Genetic Testing

Have you been re-vaccinated for the measles? For many women born after 1956 and before 1980, the answer is no. The vaccine you received as part of your childhood immunizations is wearing off! I advise my patients to get the vaccine in advance of getting pregnant. The only downside is that you must wait three months to get pregnant after getting the shot because it contains a weakened strain of measles which could cause problems for a baby.

In addition, I check with patients about chicken pox and tetanus. If you haven't had chicken pox, you may be a candidate for this vaccine. If you receive the vaccine, you should wait one to three months prior to conceiving. The tetanus shot should be administered every ten years. It can be given without any waiting period. It can also be given if necessary during pregnancy (e.g. if your skin gets cut with a rusty metal object).

"We are who we were" is a pretty good adage when it comes to being parents. Learning about your family health and genetic background can be important in preparing for a pregnancy. We can harbor genes for diseases such as cystic fibrosis or sickle cell anemia without knowing it. Fortunately, many diseases have pre-pregnancy testing available so we can discover who might be carriers of these maladies. If there is a genetic disorder in the family, I suggest the couple speak with a geneticist before getting pregnant.

Smoking and Other Drug Use

The label on a pack of cigarettes offers a succinct warning about the risks to the unborn child from exposure to smoke. We know smoking has been associated with a diminished capacity to get pregnant. In addition, smoking during pregnancy is associated with premature birth and smaller babies. Children of smokers tend to have more lung conditions (including asthma) than those of non-smokers.